Topic: Suicide
Target Population: Adults
Sector: Community-Based, Medical Setting
This program is for adults who have thought about or who have attempted suicide.
Cognitive Therapy for Suicide Prevention (CT-SP), a community-based intervention, is designed to prevent suicide and treat recent suicidal ideation and suicide attempts through restructuring how patients think about and behave in response to suicidal crises.
Results of an internal randomized controlled trial (RCT) demonstrated that participants assigned to CT-SP plus enhanced usual care (EUC) were 50% less likely to attempt suicide over an 18-month follow-up period than those receiving only EUC. Reports of depression were also lower in the CT-SP + EUC condition at the 6-, 12-, and 18-month follow-ups compared to the EUC condition. Group differences were also observed at the 6-month follow-up on measures of hopelessness, negative problem orientation, and impulsive/careless problem-solving style, but these effects dissipated by the 18-month follow-up. No differences were found between conditions on a clinician-rated measure of depression and a suicidal ideation measure due to improvements over time in both groups. Results from a pilot RCT that compared CT-SP plus treatment as usual (CT-SP+TAU) to TAU alone among a group of homeless youth at an urban drop-in center demonstrated reductions over time in both groups in suicidal ideation, perceived burdensomeness, thwarted belongingness, illicit drug use, and cognitive distortions. The decline in suicidal ideation was faster in the CT-SP+TAU group compared to TAU alone, and CT-SP+TAU was associated with lower suicidal ideation and thwarted belongingness only among those with high family network satisfaction.
CT-SP encourages participants to use different behavioral and thinking patterns during times of suicidal ideation and create a system of supports to be used when they are in crisis.
This program is delivered in three main phases:
CT-SP has been used in mental health agencies across the United States since 2002.
CT-SP is delivered by an individual therapist who must have a master's or doctoral degree in a mental health, clinical, or related field. CT-SP providers are required to attend a training workshop, use a specified program manual, and receive 4 to 6 months of phone consultation training. A 3-day online training costs $600. Please use details in the Contact section to learn more.
Considerations for implementing this program include acquiring participant buy-in, recruiting therapists who have suitable education and credentials, ensuring therapists receive training, and finding suitable space to hold sessions.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
If you are interested in implementing CT-SP, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
CT-SP consists of 10 50-minute sessions and is delivered over 6 months to 1 year. Additional booster sessions are available as needed.
Information on implementation costs was not located. Please use details in the Contact section to learn more.
To move CT-SP to the Effective category on the Clearinghouse Continuum of Evidence at least one external evaluation must be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu
You may also contact the Beck Institute for Cognitive Behavior Therapy by mail One Belmont Avenue, Suite 700 Bala Cynwyd, PA 19004-1610, phone 1-610-664-3020, email help@beckinstitute.org, or visit https://beckinstitute.org/contact-us/
Brown, G. K., Ten Have, T., Henriques, G. R., Xie, S. X., Hollander, J. E., & Beck, A. T. (2005). Cognitive therapy for the prevention of suicide attempts: A randomized controlled trial. JAMA: The Journal of the American Medical Association, 294(5), 563-570. https://doi.org/10.1001/jama.294.5.563
Ghahramanlou-Holloway, M., Bhar, S. S., Brown, G. K., Olsen, C., & Beck, A. T. (2012). Changes in problem-solving appraisal after cognitive therapy for the prevention of suicide. Psychological Medicine, 42(6), 1185-1193. https://doi.org/10.1017/S0033291711002169
Slesnick, N., Zhang, J., Feng, X., Wu, Q., Walsh, L., & Granello, D. H. (2020). Cognitive therapy for suicide prevention: A randomized pilot with suicidal youth experiencing homelessness. Cognitive Therapy and Research, 44(2), 402-411. https://doi.org/10.1007/s10608-019-10068-1
Stanley, B., Brown, G., Brent, D. A., Wells, K., Poling, K., Curry, J., … Hughes, J. (2009). Cognitive-behavioral therapy for suicide prevention (CBT-SP): Treatment model, feasibility, and acceptability. Journal of the American Academy of Child and Adolescent Psychiatry, 48(10), 1005-1013. https://doi.org/10.1097/CHI.0b013e3181b5dbfe
Wu, Q., Zhang, J., Walsh, L., & Slesnick, N. (2020). Family network satisfaction moderates treatment effects among homeless youth experiencing suicidal ideation. Behaviour Research and Therapy, 125, 10. https://doi.org/10.1016/j.brat.2019.103548
Wu, Q., Zhang, J., Walsh, L., & Slesnick, N. (2022). Illicit drug use, cognitive distortions, and suicidal ideation among homeless youth: Results from a randomized controlled trial. Behavior Therapy, 53(1), 92-104. https://doi.org/10.1016/j.beth.2021.06.004
Brown, G. K., & Jager-Hyman, S. (2014). Evidence-based psychotherapies for suicide prevention: Future directions. *American Journal of Preventive Medicine, 47(*3), S186-S194. https://doi.org/10.1016/j.amepre.2014.06.008
Chavez, L., Kelleher, K., Bunger, A., Brackenoff, B., Famelia, R., Ford, J., … Slesnick, N. (2021). Housing First combined with suicide treatment education and prevention (HOME + STEP): Study protocol for a randomized controlled trial. BMC Public Health, 21(1), 1-1128. https://doi.org/10.1186/s12889-021-11133-9
Henriques, G., Beck, A. T., & Brown, G. K. (2003). Cognitive therapy for adolescent and young adult suicide attempters: PROD. The American Behavioral Scientist, 46(9), 1258-1268.
Rudd, M. D., Bryan, C. J., Wertenberger, E. G., Peterson, A. L., Young-McCaughan, S., Mintz, J., … Bruce, T. O. (2015). Brief cognitive-behavioral therapy effects on post-treatment suicide attempts in a military sample: Results of a randomized clinical trial with 2-year follow-up. The American Journal of Psychiatry, 172(5), 441-449. https://doi.org/10.1176/appi.ajp.2014.14070843
Zhang, J., Wu, Q., & Slesnick, N. (2021). Social problem-solving and suicidal ideation among homeless youth receiving a cognitive therapy intervention: A moderated mediation analysis. Behavior Therapy, 52(3), 552-563. https://doi.org/10.1016/j.beth.2020.07.005
